Cutaneous metastases: a study of 78 biopsies from 69 patients

A retrospective study of all cases of cutaneous metastases received in the Department of Pathology during the last 13 years was performed. Seventy-eight cases from 69 patients were examined. The majority of the patients were between 60 and 80 years of age. The most frequent anatomical location for the metastases was the abdomen. Regarding the primary tumor, breast carcinoma was the most common. In females breast carcinoma was the most common, while lymphomas predominated in males. In 14 patients (17.95%), the origin of the primary tumor was unknown. In all these cases, there was no clinical suspicion of metastasis. Epidermotropism was found in only 9 out of 78 cases (11.54%). Contrary to this, vascular invasion was a common feature, being present in 49 out of 78 cases (62.82%). Necrosis was evident in 38 cases (48.72%), but it was either moderate or prominent only in 8 cases (10.26%). Inflammatory infiltrate was absent in 3 cases (3.85%), mild in 49 (62.82%), moderate in 20 (25.64%), and prominent (graded either 3 of 4 or 4 out of 4) in 5 cases (6.41%). The metastases involved exclusively the dermis in 26 cases (33.33%), hypodermis in 7 cases (8.97%), and dermis and hypodermis in 44 cases (56.41%). We concluded that vascular invasion is a common feature in cutaneous metastases, especially in nonhematologic neoplasms, and because sometimes is focal, it should be carefully searched.